2025 CPT code 64835
(Active) Effective Date: N/A Revision Date: N/A Surgery - Peripheral Nerve Repair Surgery Feed
Suture of one nerve in the hand or foot; median motor thenar.
Modifiers such as -51 (Multiple Procedures), -59 (Distinct Procedural Service), -78 (Unplanned Return to OR), or others may be applicable depending on the circumstances of the procedure. Consult the official CPT and NCCI guidelines for appropriate modifier usage.
Medical necessity for this procedure is established when a patient experiences significant functional impairment of the thumb due to a damaged median motor thenar nerve branch.The repair is deemed medically necessary to restore thumb function, and improve the patient's quality of life. The clinical documentation must support this medical necessity.
The clinical responsibility lies with the surgeon performing the nerve repair. This involves pre-operative assessment, surgical planning, execution of the surgical repair under appropriate anesthesia, post-operative care, and follow-up.
In simple words: This code describes a surgical procedure to repair a damaged nerve in your hand or foot that controls thumb movement.The surgeon will sew the ends of the broken nerve back together to help restore normal function in your thumb.
This CPT code, 64835, signifies the surgical repair of a single nerve within the thenar region of the hand or foot.The thenar region specifically refers to the muscles controlling thumb movement. This procedure involves suturing the severed or damaged ends of the median nerve's branch responsible for innervating these muscles. The goal is to restore both motor and sensory functions compromised by injury or trauma. The procedure may involve accessing the nerve through an existing wound or a new incision, meticulous debridement, precise trimming of nerve ends, and tension-free suturing using magnification to avoid damage to surrounding structures. Post-operative management may be required.
Example 1: A patient presents following a laceration injury to the right hand, resulting in a severed median nerve branch supplying the thenar muscles.Surgical repair is performed using microsurgical techniques to restore thumb function., A patient with a history of crush injury to the left hand requires repair of a damaged median nerve branch affecting thumb movement. The surgeon performs the repair using high-power magnification and appropriate microsurgical techniques., During a car accident a patient sustains a severe injury to the right hand which leads to a complete transection of the median nerve's thenar branch. A nerve repair is undertaken to reestablish thumb motor and sensory function.
Detailed operative report specifying the nerve repaired (median motor thenar branch), surgical technique (microsurgery), length of repair, and any other relevant details. Pre-operative and post-operative imaging (e.g., X-rays, ultrasound, nerve conduction studies) may be necessary depending on the case.Patient history detailing the mechanism of injury and the extent of the nerve damage is crucial.Physical examination findings documenting sensory and motor deficits before and after the procedure are essential.Photography of the injury may be helpful.
** Accurate coding requires thorough review of the operative report, supporting documentation, and adherence to current coding guidelines.In cases of complex repairs involving multiple nerves or extensive procedures, additional codes may be necessary.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: Refer to the CMS national Physician Fee Schedule for the most current RVU data and reimbursement rates. RVUs are impacted by geographic location and other factors.
- Global Days : The global period for this procedure may vary depending on payer specific policies. Consult the payer's guidelines for the applicable global period.
- Payment Status: Active
- Modifier TC rule: The Technical Component (TC) modifier may or may not apply depending on who performs the specific portion of the procedure. Refer to payer guidelines for further guidance.
- Fee Schedule : Historical fee schedule data is not readily available here, but can be sourced from publicly available databases or payer-specific fee schedules. This data will vary based on year and payer.
- Specialties:Plastic Surgery, Hand Surgery, Orthopedic Surgery, Neurosurgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)